Esophagogastroduodenoscopy performed by a family physician. A case series of 793 procedures.
BACKGROUND
Primary care physicians are performing an increasing number of gastrointestinal endoscopies. The purpose of this research is to present a large case series of diagnostic esophagogastroduodenoscopies (EGDs) performed by a family physician in a solo rural practice.


METHODS
We present a retrospective chart review, including demographic characteristics, indications, endoscopic and pathologic findings, and complications for every EGD performed by a family physician over a 7-year period.


RESULTS
Seven hundred ninety-three EGDs were performed on 602 patients (421 women, 181 men), with a mean age of 51.8 years. In 99% of procedures, the second portion of the duodenum was intubated. The most common indications for EGD were abdominal pain (60.5%), gastrointestinal bleeding (23.0%), dysphagia (11.6%), and heart-burn (10.7%). A total of 451 biopsies were obtained in 385 procedures, mostly from the distal esophagus (38%) or gastric antrum (37%). Common endoscopic diagnoses were gastritis (54%), esophagitis (25%), and normal study (15%). There were only two malignancies detected, one gastric lymphoma and one carcinoma metastatic to the stomach. One minor complication (0.13%) occurred, an immediate urticarial rash after intravenous meperidine.


CONCLUSIONS
Experienced family physicians can safely and competently perform diagnostic EGD and provide this important service to their community.
Pierzchajlo
R P
RP
Department of Family & Community Medicine, Mercer University School of Medicine, Macon, Georgia, USA.
Ackermann
R J
RJ
Vogel
R L
RL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004066:Digestive System Diseases / Q000175:diagnosis*; D016145:Endoscopy, Digestive System / Q000009:adverse effects / Q000706:statistics & numerical data; D005194:Family Practice / Q000193:education; D005260:Female; D005845:Georgia; D006801:Humans; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family; D012189:Retrospective Studies; D012423:Rural Health